参芪补肺汤联合孟鲁司特钠片治疗非小细胞肺癌术后慢性咳嗽的临床研究  

Clinical study of Shenqi Bufei Decoction combined with Montelukast sodium tablets in treating post-operative chronic cough in patients with non-small cell lung cancer

作　　者：李晓娣[1] 谢佳佳 王明选[1] 杨双[1] 易超 文琪 LI Xiaodi;XIE Jiajia;WANG Mingxuan;YANG Shuang;YI Chao;WEN Qi(Department of TCM-WM,Suining Central Hospital,Suining,Sichuan 629000)

机构地区：[1]四川省遂宁市中心医院中医及中西医结合科,四川遂宁629000

出　　处：《河北中医》2024年第8期1292-1296,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项(编号:2021MS377)。

摘　　要：目的观察参芪补肺汤联合孟鲁司特钠片治疗非小细胞肺癌(NSCLC)术后慢性咳嗽的临床疗效。方法将100例NSCLC术后慢性咳嗽患者按照随机数字表法分为2组,对照组50例予孟鲁司特钠片治疗,治疗组50例在对照组治疗基础上联合参芪补肺汤治疗。2组均治疗4周。比较2组治疗前后咳嗽症状、莱彻斯特咳嗽生命质量问卷(LCQ-MC)评分、肺功能指标[用力肺活量(FVC)、第1 s用力呼气容积(FEV_(1))、FEV_(1)/FVC、呼气峰流量(PEF)]、炎症指标[白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)、白细胞介素6(IL-6)]、中医证候评分,并统计2组不良反应发生率、复发率和疗效。结果治疗组总有效率98.00%(49/50),对照组总有效率82.00%(41/50),治疗组临床疗效优于对照组(P<0.05)。2组治疗后日间与夜间咳嗽症状评分均较本组治疗降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05),2组治疗后LCQ-MC评分均升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。2组治疗后FVC、FEV_(1)、FEV_(1)/FVC、PEF均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后IL-8、TNF-α、PCT、IL-6均较本组治疗降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组不良反应发生率4.00%(2/50),对照组不良反应发生率18.00%(9/50),治疗组不良反应发生率低于对照组(P<0.05)。治疗组复发率4.08%(2/49),对照组24.39%(10/41),治疗组复发率低于对照组(P<0.05)。结论参芪补肺汤联合孟鲁司特钠片治疗NSCLC术后慢性咳嗽患者疗效显著,能够有效缓解咳嗽症状,改善患者肺功能,提升LCQ-MC评分,且不良反应发生率与复发率降低,具有临床应用价值。Objective To explore the clinical efficacy of Shenqi Bufei Decoction combined with Montelukast sodium tablets in treating post-operative chronic cough in patients with non-small cell lung cancer(NSCLC).Methods A total of 100 NSCLC patients with post-operative chronic cough were randomized 1∶1 to receive Montelukast sodium tablets(the control group)or Shenqi Bufei Decoction plus Montelukast sodium tablets(the treatment group).A 4-week treatment was performed in the both groups,aiming to compare cough symptoms,Leicester Cough Questionnaire in Mandarin-Chinese(LCQ-MC)score,lung function index(forced vital capacity[FVC],forced expiratory volume in the first second[FEV_(1)],FEV_(1)/FVC,peak expiratory flow[PEF]),inflammatory markers(interleukin-8[IL-8],tumor necrosis factor-α[TNF-α],procalcitonin[PCT],interleukin-6[IL-6]),traditional Chinese medicine(TCM)syndrome score,and the incidence of adverse reactions,recurrence rate and efficacy of the two groups were statistically analyzed.Results The total effective rate of the treatment group was better than that of the control group(98.00%[49/50]vs 82.00%[41/50],P<0.05).After treatment,the daytime and nighttime cough symptom scores in the both groups were significantly lower than those before treatment(P<0.05),but the LCQ-MC scores in the both groups were significantly increased(P<0.05),and the improvements were more common in the treatment group relative to the control group(both P<0.05).After treatment,the levels of FVC,FEV_(1),FEV_(1)/FVC,and PEF in the both groups were significantly higher than those before treatment(P<0.05),and the increases were significantly higher in the treatment group compared to the control group(P<0.05).After treatment,the levels of IL-8,TNF-α,PCT,and IL-6 in the both groups were significantly lower than those before treatment(P<0.05),and which were significantly lower in the treatment group than in the control group(P<0.05).After treatment,the TCM syndrome scores of the both groups were significantly lower than those before treatment(P<0.0

关 键 词：肺癌 非小细胞型 术后 慢性咳嗽 中西医结合疗法 

分 类 号：R734.2[医药卫生—肿瘤] R256.110.58[医药卫生—临床医学]